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Jiménez-del-Barrio S, Medrano-de-la-Fuente R, Hernando-Garijo I, Mingo-Gómez MT, Estébanez-de-Miguel E, Ceballos-Laita L. The Effectiveness of Dry Needling in Patients with Hip or Knee Osteoarthritis: A Systematic Review and Meta-Analysis. LIFE (BASEL, SWITZERLAND) 2022; 12:life12101575. [PMID: 36295010 PMCID: PMC9605049 DOI: 10.3390/life12101575] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/03/2022] [Accepted: 10/04/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Osteoarthritis is one of the most common degenerative joint diseases. The main symptoms of the osteoarthritis have been linked to the presence of myofascial trigger points in the soft tissues. Dry needing (DN) is the most investigated technique for the treatment of myofascial trigger points. Thus, the aim of this study was to evaluate the effectiveness of DN in pain and physical function in patients with osteoarthritis in the short-, medium- and long-term. METHODS PubMed, Cochrane Library, PEDro, Web of Science, and SCOPUS databases were searched in September 2022. Randomized controlled trials involving DN compared to non-pharmacological interventions, sham techniques or no additional treatment were selected. Quality of the studies was assessed with PEDro scale and risk of bias with Cochrane Collaboration tool. Meta-analyses were conducted using fixed or random effects models according to the Cochrane handbook for systematic reviews of interventions. RESULTS Seven studies were included in the meta-analysis involving 291 patients with osteoarthritis. The methodological quality of the included studies ranged from fair to high. DN showed significant improvements in pain intensity (SMD = -0.76; 95% CI: -1.24, -0.29; I2: 74%) and physical function (SMD = -0.98; 95% CI: -1.54, -0.42; I2: 75%) in the short-term. No differences were found in the medium- or long-term. The risk of bias, heterogeneity, and imprecision of the results downgraded the level of evidence to very low. CONCLUSIONS Very low-quality evidence suggests a positive effect of DN for reducing pain intensity and improving physical function in the short term in patients with osteoarthritis. Further investigation is needed to determine a medium- and long-term effects.
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Affiliation(s)
- Sandra Jiménez-del-Barrio
- Clinical Research in Health Sciences Group, Department of Surgery, Ophthalmology and Physiotherapy, University of Valladolid, Calle Universidad s/N, 42004 Soria, Spain
| | - Ricardo Medrano-de-la-Fuente
- Clinical Research in Health Sciences Group, Department of Surgery, Ophthalmology and Physiotherapy, University of Valladolid, Calle Universidad s/N, 42004 Soria, Spain
| | - Ignacio Hernando-Garijo
- Clinical Research in Health Sciences Group, Department of Surgery, Ophthalmology and Physiotherapy, University of Valladolid, Calle Universidad s/N, 42004 Soria, Spain
| | - María Teresa Mingo-Gómez
- Clinical Research in Health Sciences Group, Department of Surgery, Ophthalmology and Physiotherapy, University of Valladolid, Calle Universidad s/N, 42004 Soria, Spain
| | - Elena Estébanez-de-Miguel
- Department of Physiatrist and Nursery, Faculty of Health Sciences, University of Zaragoza, Calle Domingo Miral s/N, 50009 Zaragoza, Spain
| | - Luis Ceballos-Laita
- Clinical Research in Health Sciences Group, Department of Surgery, Ophthalmology and Physiotherapy, University of Valladolid, Calle Universidad s/N, 42004 Soria, Spain
- Correspondence:
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Ceballos-Laita L, Jiménez-del-Barrio S, Marín-Zurdo J, Moreno-Calvo A, Marín-Boné J, Albarova-Corral MI, Estébanez-de-Miguel E. Effects of dry needling on pain, pressure pain threshold and psychological distress in patients with mild to moderate hip osteoarthritis: Secondary analysis of a randomized controlled trial. Complement Ther Med 2020; 51:102443. [DOI: 10.1016/j.ctim.2020.102443] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 03/14/2020] [Accepted: 05/11/2020] [Indexed: 12/24/2022] Open
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Behrangrad S, Abbaszadeh-Amirdehi M, Kordi Yoosefinejad A, Esmaeilnejadganji SM. Comparison of dry needling and ischaemic compression techniques on pain and function in patients with patellofemoral pain syndrome: a randomised clinical trial. Acupunct Med 2020; 38:371-379. [PMID: 32338532 DOI: 10.1177/0964528420912253] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND To compare the effectiveness of ischaemic compression (IC) applied directly to the knee versus dry needling (DN) with respect to pain, functional status and sensitivity to mechanical stimulation of vastus medialis obliquus (VMO) myofascial trigger points (MTrPs) in patients with patellofemoral pain syndrome (PFPS). METHODS A total of 54 patients with unilateral PFPS aged 20-30 years were selected randomly from patients referred to physical therapy clinics of Babol University of Medical Sciences in Iran. Twenty-seven patients were allocated to either IC or DN groups. Three sessions of treatment were applied over 1 week with follow-up at 1 week, 1 month and 3 months. Primary outcome measures comprised the Kujala questionnaire score for functional status, numerical pain rating scale (NPRS) for pain intensity and pressure pain threshold (PPT) for sensitivity to mechanical stimulation; these were measured and recorded before treatment and 1 week, 1 month and 3 months after the last treatment session. RESULTS There were no statistically significant differences in the between-group comparisons of any variables at the various follow-up points. Both groups (n = 27 participants each) had significant improvements (p < 0.05) in pain, functional status and PPT values at follow-up. CONCLUSIONS There were no differences in markers of pain, function or pressure sensitivity over a 3-month follow-up period between patients with PFPS treated with DN and IC. Temporal improvements in both groups suggested that the two techniques may be similarly effective for the treatment of PFPS.
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Affiliation(s)
- Shabnam Behrangrad
- Department of Physical Therapy, Monash University, Melbourne, VIC, Australia
| | - Maryam Abbaszadeh-Amirdehi
- Mobility Impairment Research Center, Department of Physiotherapy, School of Rehabilitation, Babol University of Medical Sciences, Babol, Iran
| | - Amin Kordi Yoosefinejad
- Rehabilitation Research Center, Department of Physical therapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
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Cao L, Gao Y, Wu K, Li Y, Chen C, Yuan S. Sympathetic hyperinnervation in myofascial trigger points. Med Hypotheses 2020; 139:109633. [PMID: 32087493 DOI: 10.1016/j.mehy.2020.109633] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 02/09/2020] [Accepted: 02/13/2020] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To evaluate the local distribution and activity of sympathetic nerves in myofascial trigger points (MTrPs) and explore the pathological mechanism of myofascial pain syndrome (MPS) using a rat model of disease. METHODS MPS was modeled in the model group (MG) by a combination of blunt trauma and eccentric exercise in Sprague-Dawley rats (n = 8). Eight rats were randomly assigned to the control group (CG). Histopathology was applied to detect the local conditions of the MTrPs. Tyrosine hydroxylase (TH), nerve growth factor (NGF), and norepinephrine (NE) were detected in the MTrPs to evaluate sympathetic remodeling. RESULTS Muscle fiber rupture, atrophy and shape irregularity were universally observed in the MTrPs. TH expression was significantly increased in the MG, as detected by immunofluorescence, and NGF and TH expression was also higher in MTrPs in the MG than in MTrPs in the CG, as determined by immunohistochemistry. Furthermore, the expression of NE was significantly increased in MTrPs, as determined by ELISA. CONCLUSION There was sympathetic hyperinnervation in MTrPs, which could partially explain the symptoms of MTrPs and is an interesting and useful new perspective regarding the diagnosis and treatment of MPS. PERSPECTIVE The sympathetic nerves in MTrPs are remodeled, leading to sympathetic hyperinnervation. Sympathetic hyperinnervation can partially explain the symptoms of MPS. The pathological mechanism of sympathetic hyperinnervation may be a new perspective for the diagnosis and treatment of MPS.
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Affiliation(s)
- Lei Cao
- Department of Anesthesiology, Hainan Province Hospital of Traditional Chinese Medicine, Haikou, Hainan, China
| | - Yanping Gao
- Academy of Orthopedics, Guangdong Province, The Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong, China
| | - Kai Wu
- Department of Orthopaedics, School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Yikai Li
- Academy of Orthopedics, Guangdong Province, The Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong, China; Department of Orthopaedics, School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Chao Chen
- Department of Orthopaedics, School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Shiguo Yuan
- Academy of Orthopedics, Guangdong Province, The Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong, China.
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Sánchez-Romero EA, Pecos-Martín D, Calvo-Lobo C, García-Jiménez D, Ochoa-Sáez V, Burgos-Caballero V, Fernández-Carnero J. Clinical features and myofascial pain syndrome in older adults with knee osteoarthritis by sex and age distribution: A cross-sectional study. Knee 2019; 26:165-173. [PMID: 30528723 DOI: 10.1016/j.knee.2018.09.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 09/30/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND A source of myofascial pain and myofascial trigger points (MTrPs) in muscles of the knee area could play a crucial role in the management of pain in osteoarthritis patients. The aim of this study was to describe and compare demographic, clinical and myofascial pain syndrome characteristics in older adults with knee osteoarthritis by sex and age distribution. METHODS A cross-sectional study was carried out. 114 patients with osteoarthritis were recruited in older-adult care centers. The diagnosis of active and/or latent MTrPs (AMTrPs/LMTrPs) was performed. Numerical Pain Rating Scale, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Barthel Index, Timed Up and Go Test (TUG), Mini-Mental State Examination, EuroQol Group 5-Dimension Self-Report Questionnaire, chronicity, number of falls, and medication use were collected. All data were compared by sex (male or female) and age (< 70, 70-80, or > 80 years) distributions. RESULTS The most prevalent muscles with AMTrPs and LMTrPs were the quadriceps vastus medialis (75.43%) and lateralis (65.78%), respectively. The clinical characteristics showed significant differences (P<0.05) for chronicity, WOMAC functionality and total scores, TUG, falls rate and medication between males and females, as well as for chronicity, Barthel index and TUG between age distributions. There were not any significant differences (P>0.05) by sex or age distribution according to the number and presence of active and latent MTrPs. CONCLUSIONS The demographic and clinical features of older adults with knee osteoarthritis may be influenced by sex and age distribution. Nevertheless, the myofascial pain syndrome associated with knee osteoarthritis did not seem to be related to sex or age distribution.
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Affiliation(s)
- Eleuterio A Sánchez-Romero
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Alcorcón, Madrid, Spain
| | - Daniel Pecos-Martín
- Department of Physical Therapy of Alcalá University, Alcalá de Henares, Madrid, Spain; Physiotherapy and Pain Group, Spain
| | - Cesar Calvo-Lobo
- Nursing and Physical Therapy Department, Faculty of Health Sciences, University of León, Ponferrada, León, Spain.
| | | | | | | | - Josué Fernández-Carnero
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Alcorcón, Madrid, Spain; La Paz Hospital Institute for Health Research, IdiPAZ, Madrid, Spain; Grupo Multidisciplinar de Investigación y Tratamiento del Dolor, Grupo de Excelencia Investigadora URJC-Banco de Santander, Spain
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Brodie MA, Lovell NH, Redmond SJ, Lord SR. Bottom-up subspace clustering suggests a paradigm shift to prevent fall injuries. Med Hypotheses 2015; 84:356-62. [DOI: 10.1016/j.mehy.2015.01.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Accepted: 01/16/2015] [Indexed: 10/24/2022]
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Sikdar S, Wei Q, Cortes N. Dynamic ultrasound imaging applications to quantify musculoskeletal function. Exerc Sport Sci Rev 2014; 42:126-35. [PMID: 24949846 DOI: 10.1249/jes.0000000000000015] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Advances in imaging methods have led to new capability to study muscle and tendon motion in vivo. Direct measurements of muscle and tendon kinematics using imaging may lead to improved understanding of musculoskeletal function. This review presents quantitative ultrasound methods for muscle dynamics that can be used to assess in vivo musculoskeletal function when integrated with other conventional biomechanical measurements.
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Affiliation(s)
- Siddhartha Sikdar
- 1Department of Bioengineering, George Mason University, Fairfax; and 2Sports Medicine Assessment, Research & Testing (SMART) Laboratory, George Mason University, Manassas, VA
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